Department of Clinical Pharmacology, Faculty of Pharmaceutical Sciences, Niigata University of Pharmacy and Applied Life Sciences, Niigata, Japan.
Department of Hematology, Endocrinology and Metabolism, Niigata University of Graduate School of Medicine and Dental Sciences, Niigata, Japan.
Cardiovasc Ther. 2017 Oct;35(5). doi: 10.1111/1755-5922.12283.
Chronic heart failure (CHF) involves fluid retention and volume overload, leading to impaired cardiac function. In these conditions, diuretic agents are most commonly used to treat edema and thereby reducing the volume load on the failing heart. There are several other beneficial effects of diuretics apart from their action on urinary excretion.
To identify the effects of diuretic agents on adverse cardiac remodeling in CHF, this study was carried out, where we have compared the effects of torasemide and spironolactone in a rat model of dilated cardiomyopathy induced by porcine cardiac myosin-mediated experimental autoimmune myocarditis.
Cardiac protein expression levels of inflammation, endoplasmic reticulum stress, and fibrosis markers were upregulated in the hearts of CHF rats, while treatment with either torasemide or spironolactone has downregulated their expression. The effect produced by spironolactone on cardiac fibrosis markers was comparably lesser than torasemide. Further, immunohistochemical analysis and histopathological studies have provided evidence to confirm the beneficial effects of these drugs on adverse cardiac remodeling in rats with CHF.
Torasemide treatment has benefits against adverse cardiac remodeling in CHF rats, which was better than the protection offered by spironolactone.
慢性心力衰竭（CHF）涉及液体潴留和容量超负荷，导致心脏功能受损。在这些情况下，利尿剂最常用于治疗水肿，从而减轻衰竭心脏的容量负荷。除了对尿排泄的作用外，利尿剂还有其他一些有益的作用。
为了确定利尿剂对 CHF 中不良心脏重构的影响，进行了这项研究，我们比较了托拉塞米和螺内酯在猪心肌肌球蛋白介导的实验性自身免疫性心肌炎诱导的扩张型心肌病大鼠模型中的作用。
CHF 大鼠心脏中的炎症、内质网应激和纤维化标志物的心脏蛋白表达水平上调，而用托拉塞米或螺内酯治疗可下调其表达。螺内酯对心脏纤维化标志物的作用比托拉塞米小。此外，免疫组织化学分析和组织病理学研究提供了证据，证实这些药物对 CHF 大鼠不良心脏重构有有益作用。
托拉塞米治疗对 CHF 大鼠的不良心脏重构有好处，优于螺内酯的保护作用。
